Individual
MS. CONNIE R SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
3431 S PACIFIC HWY, #45, MEDFORD, OR 97501-8832
(541) 512-8714
Mailing address
3431 S PACIFIC HWY, #45, MEDFORD, OR 97501-8832
(541) 512-8714
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12697
OR
Other
Enumeration date
01/02/2009
Last updated
01/02/2009
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